A Cochrane review [Abstract] 1 included 14 studies testing 90 and 180 mg/day of nimodipine for 12 and 24 weeks. Diagnoses in the trials covered Alzheimer's disease (AD) only (2 trials), cerebrovascular dementia (CVD) only (9 trials), or AD, CVD and mixed disease together (3 trials). By pooling all available outcome data (9 trials, 2 492 patients), whatever the diagnosis of the patients, there was a benefit associated with nimodipine (90 mg/day at 12 weeks) compared with placebo on the SCAG scale (WMD -7.59, 95% CI -9.87 to -5.31) on clinical global impression (WMD -0.87, 95% CI -1.07 to -0.67) and cognitive function (SMD 0.61, 95% CI 0.42 to 0.81) but not on scales assessing activities of daily living. When the AD trials and the VD trials were pooled separately similar significant results were found for the 90 mg/day dose of nimodipine at 12 weeks.
Comment: The quality of evidence is downgraded by limitations in study quality (including poor reporting) and by potential reporting bias (most of the trials sponsored by the manufacturer).
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